How To Fix Remark Code M581 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N374 means that the primary Medicare Part A insurance has been exhausted, and a Part B Remittance Advice is required. This code is used to indicate the need for additional documentation or information related to Medicare Part B claims.

1. Description

Remark Code N374 indicates that the primary Medicare Part A insurance coverage has been fully utilized, and a Part B Remittance Advice is necessary for further processing. The official description states: ‘Primary Medicare Part A insurance has been exhausted, and a Part B Remittance Advice is required.’ This remark code serves as a notification to healthcare providers and insurance companies that additional documentation or information is needed to proceed with Medicare Part B claims.

2. Common Reasons

1. Exhaustion of Medicare Part A benefits: This can occur when a patient has reached the maximum coverage limit for their Medicare Part A insurance.
2. Transition from Medicare Part A to Part B: When Part A benefits are exhausted, patients may need to switch to Medicare Part B for continued coverage.
3. Need for Part B Remittance Advice: The remark code indicates that a Part B Remittance Advice is required to process claims under Medicare Part B.

3. Next Steps

1. Submit a Part B Remittance Advice: Healthcare providers should ensure that the necessary Part B Remittance Advice is submitted along with the claim to facilitate processing.
2. Verify exhaustion of Medicare Part A benefits: Confirm that the patient’s Medicare Part A benefits have been fully utilized before submitting claims under Medicare Part B.
3. Coordinate with the patient and Medicare: Communicate with the patient and Medicare to ensure a smooth transition from Part A to Part B coverage.

4. How To Avoid It

1. Monitor Medicare Part A benefits: Keep track of the patient’s Medicare Part A coverage to anticipate the need for a transition to Part B.
2. Submit claims promptly: Timely submission of claims can help avoid delays in processing and the need for additional documentation.
3. Stay informed about Medicare guidelines: Stay updated on Medicare guidelines and requirements to ensure accurate and complete claim submissions.

5. Example Cases

1. Case 1: A claim is denied because the primary Medicare Part A insurance has been exhausted, highlighting the need for a Part B Remittance Advice.
2. Case 2: A claim adjustment occurs due to the absence of a Part B Remittance Advice, emphasizing the importance of submitting the required documentation.

Source: Remittance Advice Remark Codes